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Morphometric studies in duodenal biopsies from patients with coeliac disease: the effect of the steroid fluticasone propionate
Author(s) -
ZAITOUN A.,
RECORD C. O.
Publication year - 1991
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.1991.tb00016.x
Subject(s) - medicine , coeliac disease , fluticasone , fluticasone propionate , gastroenterology , steroid , corticosteroid , endocrinology , disease , hormone
SUMMARY Morphometric measurements have been performed on small intestinal biopsy specimens from patients with untreated coeliac disease before and after six weeks oral treatment with a steroid of low systemic bioavailability (fluticasone propionate). Measurements were obtained by point counting and also by a computer‐aided measuring system with reference to a constant area of the muscularis mucosa. Fluticasone propionate led to a parallel reduction in the intra‐epithelial lymphocyte count within the surface ( P < 0.001) and crypt epithelium ( P < 0.01). The intra‐epithelial lymphocyte count assessed by reference to constant areas of the muscularis mucosa and surface epithelium were decreased two‐fold ( P < 0.01) and seven‐fold ( P < 0.001) respectively. Fluticasone propionate treatment also led to significant increases in the absorptive surface epithelium as shown by an increase in the villus: crypt ratio ( P < 0.01), the epithelial cell height ( P < 0.01) and two‐ to three‐fold increases in the area and length of the surface epithelium ( P < 0.001). Short‐term fluticasone propionate treatment appears to exert a powerful beneficial effect upon duodenal morphology in patients with coeliac disease. Whether the alterations seen are comparable to a similar period of gluten withdrawal is not yet known.